Test Bank For
Lehne's Pharmacology for Nursing Care
11th Edition
By
Jacqueline Burchum, Laura Rosenthal
Test Bank For
Lehne's Pharmacology for Nursing Care
11th Edition
By
Jacqueline Burchum, Laura Rosenthal
Chapter 112: Potential Weapons of Biologic, Radiologic, and Chemical Terrorism
Burchum: Lehne’s Pharmacology for Nursing Care, 11th Edition
MULTIPLE CHOICE
1. A patient reported to have been exposed to mustard gas is brought to the emergency
department. The patient‘s skin is red and swollen with small blisters, and the patient‘s eyes are red
and tearing. The patient has a runny nose and a dry, barking cough. What should the nurse‘s initial
action be?
a. Prepare for renal dialysis.
b. Provide oxygen and prepare for mechanical ventilation.
c. Remove the patient‘s clothing and clean the skin with soap and water.
d. Rush the patient to the intensive care unit for cardiorespiratory monitoring.
ANS: C
Patients exposed to sulfur mustard should undress immediately and wash three times with soap and
water. Renal dialysis is not indicated. Oxygen may be useful but is not as important as
decontamination. Rushing the patient to the ICU should not be the initial action.
PTS: 1
,Test Bank For
Lehne's Pharmacology for Nursing Care
11th Edition
By
Jacqueline Burchum, Laura Rosenthal
2. A nurse is teaching a course in bioterrorism to a group of military nurses. Which statement by a
military nurse indicates understanding of the teaching?
a. ―Although smallpox has been eradicated, it remains a threat.‖
b. ―Anthrax is spread rapidly from person to person.‖
c. ―Pneumonic plague is not transmitted from person to person.‖
d. ―Terrorists spreading tularemia would most likely put it in the water supply.‖
ANS: A
Smallpox has been eradicated as an endemic disease but it remains a threat because so many
people are un-immunized. The virus is still available in laboratories throughout the world.
Anthrax is not spread from person to person. Pneumonic plague is spread from person to person.
Tularemia would be spread by terrorists as an aerosol.
PTS: 1
3. A nurse responds when a patient asks why the smallpox vaccine is no longer given. Which
statement by the patient indicates a need for further teaching? a. ―The smallpox vaccine can cause
serious side effects.‖
b. ―The smallpox vaccine can confer protection when given after exposure.‖
c. ―The smallpox vaccine is too expensive to give routinely.‖
d. ―The smallpox vaccine may cause live virus to spread to others.‖
ANS: C
The smallpox vaccine can cause serious side effects and the live virus in the vaccine may be
transmitted to others. Because it can confer protection even after exposure to the illness, it may be
given when needed. It is not true that it is withheld because it is too expensive.
PTS: 1
4. A group of people has been exposed to ricin by inhalation of ricin mist. When preparing to receive
these victims in the emergency department, nurses will prepare to: a. Administer antidotes.
b. Give chelating agents.
,Test Bank For
Lehne's Pharmacology for Nursing Care
11th Edition
By
Jacqueline Burchum, Laura Rosenthal
c. Provide respiratory support.
d. Start hemodialysis.
ANS: C
Within a few hours of inhaling ricin mist, victims experience coughing, tightness in the chest,
difficulty breathing, nausea, and muscle aches. The airway may become severely inflamed and
edematous and breathing can become extremely difficult. Management of poisoning with ricin is
purely supportive. There is no antidote or chelating agent. Hemodialysis is not indicated.
PTS: 1
5. Terrorists have detonated a ―dirty bomb‖ in a shopping center. Nurses are called to the site to
assist with triage of victims. Besides treating injuries incurred from the blast itself, the priorities for
treatment for most of the victims will include:
a. Administering potassium iodide as soon as possible.
b. Giving Prussian blue and monitoring electrolytes.
c. Monitoring urine and stool samples for radioactivity.
d. Removing clothing and bathing victims.
ANS: D
The primary danger from a dirty bomb is the blast itself, and not the radiation, since dispersal of the
radiation is limited to a relatively small area. Persons exposed should remove clothing as soon as
possible and then decontaminate the skin by showering or bathing. Since dirty bombs do not
release iodine-131, taking potassium iodide is of no benefit. Prussian blue is used to hasten
excretion of radioactive cesium and radioactive and non-radioactive thallium. Patients treated with
Prussian blue should have close monitoring of stools and urine.
PTS: 1
6. A member of a community disaster response team received the smallpox vaccine 3 weeks ago
and sees a nurse for a follow-up appointment. The nurse examines the area and should expect to
see a:
a. Necrotic vesicle
, Test Bank For
Lehne's Pharmacology for Nursing Care
11th Edition
By
Jacqueline Burchum, Laura Rosenthal
b. Small area of scarification
c. Small, fluid-filled blister
d. Red bum.
ANS: B
With smallpox vaccination, the scab falls off in the third week, leaving a small scar; the nurse should
expect to see a scar. A necrotic vesicle would be a symptom of progressive vaccinia (vaccinia
necrosum), which develops almost exclusively in those who are immunodeficient. There is
progressive necrosis at the inoculation site. During the first week after inoculation, the bump
becomes a blister, which begins to dry and develop a scab. Within 3 to 4 days of administration of
the vaccine, a red, itchy bump appears.
PTS: 1
7. A patient is admitted to the hospital with fever, cough, malaise, and weakness. 48 hours later, the
symptoms have become progressively worse, and they progress to severe respiratory distress,
septicemia, and hemorrhagic meningitis. The nurse recognizes these signs and symptoms as: a.
tularemia.
b. smallpox.
c. inhalation anthrax.
d. pneumonic plague.
ANS: C
Inhalation anthrax is characterized by fever, cough, malaise, and weakness, which progress 2 to 3
days later to severe respiratory distress, septicemia, and hemorrhagic meningitis. Tularemia is
characterized by fever, headache, chills, rigors, body aches, sneezing, and sore throat. Pneumonia
and pleuritis may develop. Smallpox is manifested by a vesicular rash, which this patient does not
have. Fever is a characteristic of both inhalational anthrax and smallpox. Pneumonic plague is
manifested by high fever, cough, dyspnea, and hemoptysis, as well as gastrointestinal symptoms.
PTS: 1
